Delirium on hospital admission in aged hip fracture patients: Prediction of mortality and 2-year functional outcomes

Background. Hip fracture patients are at increased risk of confusion or del irium due to the trauma associated with the injury and the rapid progressio n to hospitalization and surgery, in addition to the pain and loss of funct ion experienced. Hip fracture patients who develop delirium may require lon ger hospital stays, are more often discharged to long-term care, and have a generally poor prognosis for returning home or regaining function in activ ities of daily living (ADL). Methods. The present study examines the impact of delirium present on hospi tal admission in a sample of 682 nondemented, aged hip Fracture patients re siding in the community at the time of their fracture. in-hospital assessme nts designed to assess both prefracture and postfracture functioning, as we ll as follow-up interviews at 2, 6, 12, 18, and 24 months postfracture, wer e obtained From participants. Results. Analyses indicate that baseline or admission delirium is an import ant prognostic predictor of poor long-term outcomes in persons without know n cognitive impairment, after controlling For age, gender, race, comorbidit y, and functional status. Delirium at admission (i.e., prior to surgery) wa s associated with poorer functioning in physical, cognitive, and affective domains at 6 months postfracture and slower rates of recovery. impairment a nd delays in recovery may be Further exacerbated by increased depressive sy mptoms in confused patients over time. Delirium on hospital admission was n ot a significant predictor of mortality after adjustment for confounding fa ctors. Conclusions. The: present findings further emphasize the significance of im mediate detection and treatment of delirium in hip fracture patients to ame liorate the short and long-term effects of acute confusion on functional ou tcomes.